clinical.carelonmedicalbenefitsmanagement.comCarelon Clinical Connections |

Clinical Connections Clinical news and trends What we’re watching in the ever-evolving healthcare landscape. Home Evidence in action On the horizon Behind the scenes Medicine advances rapidly. At Carelon Medical Benefits Management, we understand emerging science and real-world clinical practice and apply what’s been proven effective to benefit health plan members. Our team of specialized clinicians, medical librarians, and evidence researchers conduct rigorous, robust evidence surveillance. We collect and analyze data from thousands of studies, guidelines, and the many millions of case reviews we conduct each year. Our research informs the clinical criteria embedded into our automated platform and fuels the logic of our review process, creating an efficient experience that’s also clinically credible. This commitment to clinical best practices is the foundation of our business. Evidence in action The most interesting articles encountered during our literature surveillance. ASCO Annual Meeting Jul 2022 The American Society of Clinical Oncology (ASCO) held its annual meeting June 3-7, 2022, in Chicago, Illinois, with the theme Advancing Equitable Cancer Care Through Innovation.” Several thousand studies... New and updated Appropriateness Criteria from the American College of Radiology Jul 2022 In May 2022, the American College of Radiology (ACR) published several new and updated Appropriateness Criteria. The following new Criteria were published: Pelvic Floor Dysfunction in Females Osteomyelitis or... Genomic sequencing of solid tumors to guide cancer therapy Apr 2022 Genetic testing is a rapidly growing area in which technology can outpace the understanding of its appropriate use. In the area of tumor genetics, this is especially true. An increasing number of cancer... The impact of low-value cardiovascular care Apr 2022 In a scientific statement released for publication, the American Heart Association Council on Quality of Care and Outcomes Research examines the issue of low-value cardiovascular care, including a discussion... Same day discharge following joint replacement surgery Jan 2022 A recent study published in the Journal of Bone & Joint Surgery examined same-day discharge following total joint replacement in patients considered to be at increased risk for adverse events. ((Reddy NC,... New guidance for evaluation of chest pain Jan 2022 The American Heart Association and American College of Cardiology recently released a comprehensive guideline for evaluation and diagnosis of chest pain.((Gulati M, Levy PD, Mukherjee D, et al. 2021... Management of stable coronary artery disease Sep 2021 Coronary artery disease (CAD) is a common condition which exists across a spectrum ranging from asymptomatic, subclinical disease to acute, life-threatening events. Between these extremes is a large... Colorectal cancer screening Jul 2021 On May 18th, 2021, the U.S. Preventive Services Task Force (USPSTF) issued a revised recommendation statement on screening for colorectal cancer. ((US Preventive Services Task Force. Screening for Colorectal... Trends in cancer incidence and mortality Jul 2021 A cross sectional study published in the JAMA Open Network in April 2021 examines U.S. population-based cancer statistics and census data to predict trends in cancer incidence and mortality over the next 20... PET radiotracers in prostate cancer Jul 2021 The FDA recently approved two new radiotracers for use in prostate cancer. Gallium (Ga)-68 prostate-specific membrane antigen (PSMA) was the first, approved in December of 2020. PSMA is a protein unique to... « Older Entries On the horizon Current issues with far-reaching impact. FDA approval of Pluvicto Jul 2022 On March 23, 2022, the FDA approved the therapeutic radiopharmaceutical agent Pluvicto™ (lutetium Lu 177 vipivotide tetraxetan, also known as 177Lu-PSMA-617) for treatment of metastatic prostate cancer... Evaluation and treatment of gastroesophageal reflux disease Apr 2022 The American College of Gastroenterology recently published a clinical practice guideline for the evaluation and treatment of gastroesophageal reflux disease (GERD).((Katz PO, Dunbar KB, Schnoll-Sussman FH,... Updated CMS Lung Cancer Screening recommendations Apr 2022 In March 2021, the U.S. Preventative Services Task Force (USPSTF) updated their guidelines for lung cancer screening with low-dose CT (LDCT).((Centers for Medicare & Medicaid Services. Screening for lung... LiverMultiScan and cone-beam breast CT CPT codes Jan 2022 Carelon has received several questions regarding upcoming codes for LiverMultiScan (LMS) – CPT 0648T/0649T and Cone-beam breast CT (CBCT) – CPT 0633T-0638T. Additional information and rationale is provided... AHRQ Technology Assessment: CPAP for treatment of obstructive sleep apnea Sep 2021 The Agency for Healthcare Research and Quality (AHRQ) is preparing to publish a technology assessment of continuous positive airway pressure (CPAP) for treatment of obstructive sleep apnea (OSA ).((Agency for... Breast MRI as an adjunct to mammography for cancer screening Jul 2021 The DENSE trial (Dense Tissue and Early Breast Neoplasm Screening) is an ongoing study designed to help define the role of breast MRI in screening women with dense breast tissue. In an article published in... Evaluating the role of coronary CT angiography in initial assessment of CAD Apr 2021 The American College of Cardiology (ACC) is expected to update its recommendations for evaluation of chest pain to include coronary CT angiography (CCTA) as a first line study. If this happens, it will... Breast cancer screening recommendations Apr 2021 In January 2021, the U.S. Preventive Services Task Force (USPSTF) began the process of updating its recommendations for breast cancer screening. The announcement and call for public comment on the research... Behind the scenes Get to know some of the great people in our clinical team . Evidence assessment Jul 2022 The Carelon Guideline Development team conducts a systematic evidence review to inform both new guidelines and annual updates. A key component of the process is an assessment of the collected evidence by a... CT contrast shortage Jul 2022 On May 9, 2022, the United States Food and Drug Administration added Omnipaque™ and Visipaque™ to their drug shortage list due to the shutdown of a GE Healthcare plant in Shanghai. Though the plant has since... myNEXUS Apr 2022 myNEXUS delivers integrated clinical support services for approximately 3.5 million Medicare Advantage members across 23 states through their comprehensive home benefit management program for payors. myNEXUS... Search function and archives added to AIM guidelines Jan 2022 Carelon recently launched enhancements to Carelon guidelines.* Developed based on client, reviewer and provider feedback, the guidelines now have many requested features including the following: Relevance... Evidence review process Sep 2021 Carelon clinical appropriateness guidelines are developed using a robust evidentiary review process. A team of clinicians and medical librarians conduct literature review using structured search... Oncology Pathways Jul 2021 The Carelon Oncology Pathways Program provides information to providers on high quality, cost-effective treatment options through the publication of optimal regimens used in the practice of medical oncology.... Knowledge Services Apr 2021 All guideline development work performed at Carelon begins with the Knowledge Services team. This team of graduate level professionals includes a methodologist and a group of experienced medical librarians... recent posts Evidence assessment CT contrast shortage FDA approval of Pluvicto EXPLORE BY SOLUTION Cardiology Oncology Radiology Tags CCTA COVID-19 CT MRI PET radiotracers Ultrasound For questions about a specific case, call (800) 252-2021 for assistance. © 2023 Carelon Medical Benefits Management. All rights...